Correlation Analysis Of Blood Zinc,Copper,Copper/Zinc Ratio And Coronary Artery Calcification In Patients With Chronic Kidney Disease

Objective To explore the influence and predictive value of serum zinc,copper,copper/zinc ratio on coronary artery calcification（CAC）in patients with chronic kidney disease.Methods Using the cross-sectional analysis method,274 patients with chronic kidney disease were studied.According to the coronary artery calcification score,the patients were divided into calcification group and non-calcification group,and the clinical data and laboratory indicators of the two groups were compared.Spearman correlation analysis was used to analyze CAC related factors,binary logistic regression analysis CAC risk factors,and ROC curve to explore the predictive value of zinc,copper,and copper/zinc ratios on CAC.Results（1）The detection rate of CAC in 274 CKD patients was 47.8%,including the non-calcified group（CACS=0,n=143）and the calcified group（CACS>0,n=131）.Compared with the non-calcified group,the calcified group had higher levels of age,diabetes prevalence,insulin usage,CKD 5d and maintenance hemodialysis,serum creatinine,serum magnesium,high-sensitivity C-reactive protein,and alkaline phosphatase levels,while the serum zinc level was lower（P<0.05）.The serum zinc level of calcified group（77.09 μmol/L ±15.84 μmol/L）was lower than that of non-calcified group（88.21 μmol/L ±11.55 μmol/L）.The ratio of serum copper（13.99 μmol/L ±3.76μmol/L）and copper/zinc（0.19±0.08）were higher than those of non-calcified group（12.10±3.99 μmol/L,0.14±0.05）.（2）Spearman correlation analysis showed that serum zinc level（r=-0.387,P<0.001）was negatively correlated with coronary artery calcification score（CACS）.Serum copper（r=0.356,P<0.001）and copper/zinc ratio（r=0.477,P<0.001）were positively correlated with CACS.Binary logistic regression analysis showed that high age（OR=1.085,P<0.001）,high levels of copper（OR=1.114,P<0.001）,copper-zinc ratio（OR=1.143,P<0.001）and low zinc（OR=0.948,P<0.001）)were the independent risk factor for coronary calcification.（3）ROC curve analysis showed that the AUC of zinc,copper,and copper-zinc ratios were 0.301,0.650,0.716（P<0.001）.Conclusions（1）The detection rate of coronary artery calcification in patients with chronic kidney disease was 47.8%.（2）The coronary artery calcification score of patients with chronic kidney disease was positively correlated with age,copper,copper/zinc ratio,but negatively correlated with zinc.（3）Patients with chronic kidney disease with high age,diabetes,high levels of copper,copper/zinc ratio,and low zinc have a higher risk of CAC,and the copper/zinc ratio has a better predictive value for the occurrence of CAC.